1. Field of the Invention
The subject invention relates to surgical instrument for performing endoscopic and open surgical procedures, and more particularly to surgical instrument having an end portion which can articulate a prosthetic implant, such as a heart valve, in a patient's body during a surgical procedure.
2. Background Art
In endoscopic surgery it is often advantageous to be able to precisely orient a prosthetic implant in a surgical site within the patient's body. One example in which it is critical to properly orient a prosthetic implant is in the medical field of open heart surgery and particularly in the field of prosthetic heart valve implantation. Open heart surgery, especially aortic and mitral valve replacement surgery, requires specialized tools adapted for these highly technical and precise procedures. In prosthetic heart valve implantation, for example, specially adapted instruments for handling the prosthetic valve include valve sizers, valve rotators, leaflet testers, and handles for the rotators. Many of the instruments needed for prosthetic valve replacement surgery are sold in kits, e.g., such as those manufactured by CARBOMEDICS.RTM. of Austin, Tex.
In a typical valve replacement procedure the surgeon will utilize a valve sizer to determine the proper size prosthetic replacement valve for the patient. The prosthetic valve is mounted on a valve holder and handle assembly and delivered to the surgical site. Often times it is necessary to rotate the valve to obtain the best orientation with respect to the location of the patients remnant valve leaflets and chordae tendinea. Improper orientation of the prosthetic valve will cause impaired function of the synthetic leaflets due to interference with one or more of the above structures. Thus, the surgeon places the valve into position with one instrument and then must utilize another separate instrument for rotation and anatomical orientation of the leaflets.
Recent advances in prosthetic heart valve implantation include the advent of newer minimally invasive and endoscopic surgical approaches. These new surgical procedures are less stressful on the coronary care patient and reduce patient recovery times as well as increasing the success of the overall surgical procedure. However, the reduced surgical field makes positioning and orientation of the valves even more difficult and tedious.
Prior to the present invention, however, there was not a single instrument which was adapted for conventional as well as minimally invasive or endoscopic prosthetic implantation surgery, such as endoscopic valve replacement surgery, which could be used to hold a prosthetic implant for placement at the surgical site and also simultaneously be utilized to rotate the prosthetic implant into proper anatomical orientation.